Altitude or dehydration?

For some reason I started this post months ago on the subject of getting ill during the Inca Trail trip, and never finished it. So here it is...

After a bowl of soup for dinner and a largely sleepless night, after the Dead Womans Pass day, I woke up on Boxing Day feeling better but terribly dehydrated. We had no fresh water available except what was carried by the porters, and I hadn't thought to replenish my water bottle the previous night. With blood sugars around the 25 mark most of the night (extremely high) I changed my infusion set and refilled my pump with fresh insulin, assuming that was the cause. In fact, it was more likely to have been the impact on my body of being so ill, and the dehydration of course made it worse. However after tea and eggs for breakfast I felt fit and well, and had no problems during the day's walking, arriving as one of the first at the campsite that evening. A couple of hours later, I realised my blood sugar was low, and took some glucose, then went into the dining tent with some of the others for a cup of tea. I suddenly felt desperately tired, and could barely move my arms and legs. Some time later, I realised someone was shaking me, and asking if I was all right. Feeling terribly groggy, I swallowed a couple of glucose tablets, thinking my blood sugar was still low. Juan was summoned and he came over and made me check my blood sugar. To my surprise it was 8, but still groggy, I just assumed my body had been a bit slow in feeling better. Halfway through dinner a little later, I felt everything go black. Juan and Wilson managed to get me outside to breathe some air, and when again I was barely conscious and couldn't speak, they gave me alcohol to breathe until I was semi-conscious, and then managed - somehow - to carry me up the most treacherous rocky path (in total darkness) that you can imagine, to my tent! Now shivering uncontrollably, they brought me tea and sat with me until I felt better. All I wanted to do was sleep. This was clearly a worrying turn of events because I'd been fine during the day, and we were now at much lower altitude than the previous day! No one could work out what was the problem - my blood sugar levels were fine by now, it shouldn't be the altitude any more, and although I was struggling to breathe, it wasn't asthma-related. Finally they left me, after filling two of my water bottles with hot water to put in my sleeping bag (it was an extremely cold night). I barely slept that night either, and nor did Juan, as he came to check on me in the night not once but 5 times! It rained solidly all night, and I felt so guilty that he was having to get up and check on me. At one point, I was struggling to breathe, and he sat with me for a long time, again clearly worried. Oddly, I was quite calm all this time - I didn't even have the energy to be worried. It was a long night, but again, by the morning I felt much better. Over the next couple of days I had moments when I felt terribly dizzy and faint and was frogmarched to a doctor when we got to Aguas Calientes, the first town we came to at the end of the trail. He diagnosed severe dehydration, aggravated by my having eaten virtually nothing for the last 3 days, and prescribed rest, lots of fluid, rehydration salts and plenty of food (especially rice). He would have liked to admit me to hospital but I was determined to be fit for the second part of my trip, the Amazon rainforest. Given that it was 3 hours by boat and another hour by car from any kind of doctor, he was sceptical about my fitness to do this trip in 2 days' time but arranged for another doctor to see me before I left for the jungle and to decide whether I would be allowed to go. I followed his advice to the letter and was finally deemed fit and well!

The long and short of it was that it was decided later that all my problems had been caused by dehydration, caused by a combination of altitude, the stomach bug and high blood sugars. Lesson learnt!